Birth injuries: what can we learn from the Shropshire maternity scandal?

Reports of poor care at Shropshire hospitals amount to possibly the largest scandal in the NHS’s history. This is a tragic story of avoidable deaths and serious injuries to babies and their mothers over a period of 40 years.

What is the Shropshire maternity scandal?

An interim report looks at care given at hospitals in Shrewsbury and Telford – the Royal Shrewsbury Hospital and Princess Royal Hospital, run by the Shrewsbury and Telford Hospital NHS Trust. In 2017 Jeremy Hunt, then Secretary of State for Health, ordered an investigation to look at 23 cases. The investigation uncovered so many failings that its scope has widened. Now over 600 cases are being examined. That number is only likely to increase with investigation of births reported in 2018. They include cases involving the death of 42 babies and 3 mothers. There are also reports of brain injuries to 50 children who were deprived of oxygen at birth. These are traumatic events which have a life-long impact on the people and families concerned.

What has gone wrong?

In broad terms 2 things have gone wrong.

The first is that care has at times been poor. Mothers and babies have suffered avoidable injuries or even died as a result of mistakes. The second is that investigations have been poor and so lessons have not been learned. The same mistakes have been repeated again and again.

How can birth cause brain injuries to babies?

Whilst most births are safe, it is a time of risk to mother and baby. For the baby this is a time when they go through a traumatic process and are highly vulnerable.

Sadly, some babies are injured when something happens inside the skull or brain. These are described as acquired injuries. This may be because the baby is deprived of oxygen (and this is known as hypoxia). Or it may be because the mother is ill and has an infection. At other times something happens to the umbilical cord or placenta, or the baby’s head gets stuck. In cases of shoulder dystocia one of the baby’s shoulders becomes stuck behind the mother’s pubic bone. If the shoulder is not released quickly, there is a risk of the baby being deprived of oxygen.

Other acquired injuries are the result of the failure to diagnose and treat serious conditions such as infection from Group B streptococcus or meningitis.

Babies are also at risk of traumatic injury. There are significant forces pushing the baby down the birth canal. The baby’s head can get stuck or the doctor may use forceps or ventouse (a form of suction cup) with too much force. This can cause devastating bleeding (haemorrhage) in the brain.

Brain injuries are extremely serious. They can lead to lifelong disability from conditions such as cerebral palsy. In some cases they can lead to the baby’s death.

All of this means that safe childbirth requires the best possible care. One of the things going wrong in Shropshire is that care has not been good enough. Some injuries could and should have been avoided, and sadly mistakes have been repeated over the years.

Learning from mistakes

There will always be things that go wrong. Some injuries are unavoidable. However some can be avoided. To avoid mistakes, it is vital that hospitals learn lessons from what has gone wrong in the past.

This means hospitals need to develop a culture of openness and honesty. Patients need to be told when things have gone wrong. There needs to be thorough investigation. This is not about blaming people or putting staff under pressure. It is about finding out what has gone wrong so as to learn lessons for the future.

Unfortunately this is something hospitals are not necessarily good at. None of this has happened adequately in the Shropshire hospitals. Instead errors were compounded by inadequate investigations. In fact in the rather shocking language of the report, there was a long-standing culture toxic to improvement. Lessons were not learned, and the same mistakes were repeated.

Is there a wider problem than the Shropshire maternity deaths?

Is the problem with Shropshire maternity care a one-off or has the same happened elsewhere? A recent investigation into Furness General Hospital found that failings led to the avoidable deaths of one mother and 11 babies. It criticised a culture of denial, collusion and incompetence. There were four times as many failings of care as at nearby Royal Lancaster Infirmary. Before the Shropshire maternity report, this was the largest maternity scandal in NHS history.

Much maternity care in NHS hospitals is excellent. But there are clearly things going wrong in some units and the problems in Morecambe and now Shropshire may suggest that there is a wider problem.

Claims for damages

Where mothers or babies suffer death or serious injury as a result of negligent medical care there may be a right to damages. It is particularly important the children who suffer avoidable brain injuries are able to recover damages to meet the very considerable costs of providing them with support for life. Our team of specialist solicitors can assist with these complex and serious claims, so if you would like more information, please contact us.